# JUSTIN CHAN DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205661600
- **Authorized official:** DR. JUSTIN CHAN DDS (DENTIST)
- **Authorized official phone:** (586) 556-0220

## Contact information

- **Practice address:** 65-1230 MAMALAHOA HWY STE A21, KAMUELA, HI 96743-7317
- **Practice address phone:** (586) 556-0220
- **Mailing address:** 65-1230 MAMALAHOA HWY STE A21, KAMUELA, HI 96743-7317
- **Mailing address phone:** (586) 556-0220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/04/2024
- **Last updated:** 01/16/2025